In recent studies, it has been observed that fatigue is one of the major factors contributing to fatal accidents in Bangladesh. It is increasing tremendously and alarmingly and causing the huge loss of lives and assets. In Bangladesh, heavy vehicle drivers are susceptible to frequent fatigue related accidents, thus increasing disability and social and economic vulnerability. The study aims to identify truck drivers’ causes of fatigue and other physical, socio-psychological and economic consequences on the drivers. The study was conducted during January-June 2012 in the different truck and cargo terminals of Dhaka city in Bangladesh. A total of 400 drivers were chosen purposively. Qualitative data were collected through in-depth interviews and focused group discussion methods. The study indicates that the reasons behind fatigue led injuries were the driver’s consistent working pressure, longer non-stop driving, traffic congestions, driving in drunk condition, inadequate facilities of physical and mental rests, family conflicts and long detachment from family care, owners and drivers ill relationship, harassments by police, job insecurity and income frustrations etc. The study showed that above 83% of the drivers directly or indirectly suffered from fatigue related problems. The study showed that pressure from owners and businessmen and lack of mal-nutrient food consumption were the leading causes of fatigue. The owners’ and drivers’ associations, civil society, Government of Bangladesh (GOB), NGOs and development partners should address the fatal crisis by adopting appropriate interventions to reduce the said fatigue related accidents.